Munchausen’s by Proxy Server?

December 4, 2008 at 4:05 am 9 comments

From eFluxMedia:

Neurotic self-diagnosis is usually common among med students. They study the diseases carefully and take in every symptom and, before they know it, every headache is a brain tumor and every pimple is skin cancer. The same thing happens to anyone who reads all the possible symptoms of most given diseases.

[...]

Given that access to the Internet is now widely-available, people can get medical information much faster than before. Unfortunately, these people can also get wrong medical advice and incorrect information regarding anything from symptoms to treatments or to statistics. The problem with medical misinformation is that the result may be death.

A new term was thus coined, namely “cyberchondria”, describing the effect of extensive Web browsing for information on a disease or symptom and coming to the conclusion that their cough is a sign of typhoid fever. The problem with so much information available a click away is that people prefer to ask WebMD instead of their real doctor, a laziness which can have disastrous consequences.

Also, when people start searching their symptom, they don’t stop at attributing it to one of the more common diseases, but instead associate it with the most serious and rare conditions.

TechDirt reports:

Some researchers at Microsoft have been studying cyberchondria, the phenomenon of people searching the web for medical info, then concluding they’ve got some horrible disease or affliction. They conclude that “Web search engines have the potential to escalate medical concerns.” 

Indeed, according to a recent article in the New York Times, it appears that self-diagnosis by search engine regularly leads to concluding the worst about what ails us. It’s a widespread phenomenon — roughly 2% of all Web queries included in the study were health-related and almost a quarter of the people involved in the study engaged in a least one medical search. 

–And I’m willing to bet that we behave in much the same way when it comes to our pets.

There is a stunning amount of veterinary advice available free for the searching on the interwebs. And if there’s one thing we obsess about as much our own health… heck, in many cases more than our own health — it’s the health of our beloved pets. If the Microsoft study is an indication we are, in many cases, making mountains out of molehills.

dogfart

So, if you do a web search after seeing that Rover suffers from flatulence and diarrhea you are much more likely to believe that he suffers from inflammatory bowel disease, chronic pancreatitis or exocrine pancreatic insufficiency than the much more benign (and far more common) dietary indiscretion – if articles on these much more serious and interesting diseases rank higher in your search results.

And (with apologies to our friends at Google) those nifty page ranks aren’t necessarily all they’re cracked up to be. The fact that a site on rare, debilitating diseases where people seek lots of support is more frequently linked and gets more hits than one about dogs that fart doesn’t mean that those are the diseases we are more likely to find. But — being human we tend to make a cum hoc ergo propter hoc  assumption; forget about the deviled eggs Binky stole off the counter yesterday and decide that he’s going to suffer from a debilitating disease for the rest of his life.

Binky (having now pooped the offending eggs out behind the sofa) feels great and wonders what all the fuss is about as you whisk him off to the vet for a full round of testing.

[interesting and somewhat creepy sidebar: there is a real factitious disorder referred to as Veterinary Munchausen's syndrome by proxy]

Entry filed under: behavior science, cynicism, dogs, health, pets, science. Tags: .

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9 Comments Add your own

  • 1. Caveat  |  December 4, 2008 at 3:11 pm

    Great post.

    When I worked in medical reasearch I reminded myself often that I’m lucky not to be a hypochondriac. I mean, technically, everybody could have SLE (lupus) because the symptoms are so vague and common.

    Funny too, that I often joke with my vet that I really don’t have MBP, I’m just a worrywart and can tell when things aren’t right. Since dogs and cats can go downhill quickly, if I think it’s serious I don’t like to fool around.

    They usually laugh and tell me they’re pretty sure it’s not MBP – since the test results always back me up. LOL

    Someimes I wish the little guys could talk. Then I think about that for a second….

  • 2. Audie's Gramma  |  December 4, 2008 at 4:07 pm

    I’m sure that the veterinary MBP is much more common than we can imagine. Animals aren’t medically monitored as closely as humans, and are even less able than children to protect themselves. They can’t tell about how Mommy gave them cereal that tasted funny.

    Ironically, the more we are supportive of friends and acquaintances who are caring for sick animals — the more we renounce the callous “It’s just a dog” mindset when dealing with our social contacts — the more we enable MBP. Nobody would do it if they didn’t get sympathy, attention, “support” and a sense of martyrdom validated. I worry about this sometimes on the friendly, social dog discussion lists. Some of the people with chronically sick pets whose every setback is reported in gory detail strike me as awfully hungry for attention, and awfully lacking in life achievements. On the interwebs they can have hundreds of people telling them what wonderful furmommies they are.

    The worst case I’ve ever heard of was a self-proclaimed “SAR dog handler” here in SW PA who staged the “kidnapping” of his year-old Newfie pup, complete with threatening phone call demanding ransom. He was soliciting money for a “reward fund.” And people were sending it.

    When this hit the SAR handler discussion lists, my bullshit radar pinged hard — the guy was one county over from me, claimed to have responded to a dozen searches in the past year with his pup, claimed “finds” with the pup — and I had never, not once, heard of him. Or of any of the lost person searches he claimed to have responded to. I told people that they might want to hold on to their money until there was some more information — and was denounced as bitter, evil, jealous, snobby, callous.

    The next day the story unraveled. When they found the pup’s body in the Casselman River, a plastic bag wired over his head, the sheriff, who had been suspicious all along, remembered seeing some of the same wire in the “handler’s” truck.

    Man murdered his own dog for attention. Worse, his previous dog had died under mysterious circumstances, which he blamed on “contaminated dog food from Wal-Mart.” He’d tried to get money for that, too, to no avail. Giant corporations don’t pay out when the evidence is quickly buried with no necropsy.

    This guy was desperate for attention/validation, so he claimed his pet was a SAR dog. That wasn’t enough, so he invented searches and heroic finds that never happened. Still not enough, so “kidnapping” and “murder” casting himself as the bereaved and wronged handler.

    He was convicted of filing a false report, and I think animal cruelty. Got probation.

    A friend from another SAR unit who did know him, and knew he was no real handler, told me how relieved she was that this all broke before his wife was able to get pregnant — they had been “trying” for some time. My friend was sad for both dogs — nice, untrained dogs — but sick at the thought of this guy with access to an infant. I hope the wife left him. I don’t know.

  • 3. SmartDogs  |  December 4, 2008 at 4:47 pm

    Oh yes – Munchausen’s by Internet – another well-documented factitious disorder. It’s where people log on to internet chat rooms, bulletin boards and email lists pretending to be terribly ill so they can get attention and sympathy. It is, apparently, disturbingly common — and like you, I think that there’s a lot of it going on in the dog world (can think of specific posts from lists I’m on in just the last 6 months that set my radar off). Some of these people go as far as logging on under several different names to pose as relatives or friends of the “afflicted” one.

    For those who are interested, here’s a list of clues to detect possible cases from Self Help Magazine:

    The posts consistently duplicate material in other posts, in books, or on health-related websites;

    The characteristics of the supposed illness emerge as caricatures;

    Near-fatal bouts of illness alternate with miraculous recoveries;

    Claims are fantastic, contradicted by subsequent posts, or flatly disproved;

    There are continual dramatic events in the person’s life, especially when other group members have become the focus of attention;

    There is feigned blitheness about crises that will predictably attract immediate attention;

    Others apparently posting on behalf of the individual (e.g., family members, friends) have identical patterns of writing.

  • 4. EmilyS  |  December 4, 2008 at 4:51 pm

    Well, it’s kind of “interesting” that there’s this whole slew of stories about how horrible it is to research medical conditions on the Internet. (NBC news had one last night). I can’t help wondering who’s behind it.. like doctors maybe? Because if patients get educated, they might find out their doctors don’t know everything and sometimes pretend that they do.

    For every med student self diagnosing some obscure disease, every Internet poster making up diseases to get sympathy, there’s a person who was able to read about a medical condition in reputable, reliable online sources and learn how to take control over her own health. Or her pet’s.

  • 5. Dorene  |  December 5, 2008 at 2:58 am

    As someone with a poorly-understood disability, I have to share Emily’s skepticism here. The Internet has been a life-saver for folks with my disablity because with a modicum of critical thinking skills, we’re able to network with each other and find decent lists and websites (not much in the way of blogs, for some reason) that help us manage our condition.

    One of the best doctors I’ve had (he got lured back home to NYC) used to surf the Net with me while we brainstormed what the heck to do next. My current doctor is completely okay with me bringing in web articles as it helps both of us come up with ideas as to what we should try next. And, considering all the meds I’ve been on — bother the Physican’s Desk Reference — I look up everything on RX List which is updated far more often — and if I have questions, I call my doctor — and the time I yelled at now-NYC doctor because he had prescribed more of a certian drug than was recommended, he gave me absolutely no attitude and we had a nice discussion about why he had perscribed what he had (with references) and what we would do if there was a problem (which there wasn’t). There was/is mutual respect which is why I keep going to these folks.

    OTOH, my vet completely flipped when I started bringing in Internet articles about the pets. We’ve known each other over 20 years now and since I do have good critical thinking skills, we’ve now evolved into “He doesn’t ask that these questions are based on the Internet and I don’t tell him” which is really weird as where the heck did I suddenlly get such detailed vet med knowledge, but he’s always been there for us when the pets had serious problems (most recent was dropping everything and flushing Lindsey’s kidneys on 20 minutes notice on the pet food recall, probably saving his life and most of his kidney function) so we put up with each other. But I’d rather be able to be honest with him and thinks he needs to loosen up on people trying to education themselves.

    As someone who has benefited greatly from medical information on the Net, I really believe the problem is educating folks in critical thinking skills (not an easy task in this society!), rather than “information or lack thereof” on the Net, per se.

  • 6. SmartDogs  |  December 5, 2008 at 4:09 am

    Dorene my friend,
    I think you should consider a small refresher in critical thinking. If you read the post carefully you’ll see that what I wrote is:
    A. There is a lot of health-related information on the internet; and
    B. Some people are not using that information in a healthy way.
    From that, you (and Emily) appear to be deducing that I wrote that everyone who surfs the web for health-related information or belongs to internet support groups is abusing the information. These are two very different conclusions – and the difference is important.

    The most truly helpful part of this post might actually be the information in my response to Audie’s Gramma. There are some people who join support groups not only to get attention — but to take advantage of others’ sympathy and steal their money. I have come across a few of these just in the last year and was shocked at how successful they were at getting strangers to send them money, books and other valuable things.

    By all means use the web to get medical and veterinary information (I do) – but use it wisely.

  • 7. bluntobject  |  December 5, 2008 at 4:21 am

    One of the really nice things about this series of tubes is that it’s much easier to get access to research papers from refereed journals. Bringing in a printout from The Lancet or some such does wonders for getting past the usual “I read it on the internet so it must be true” skepticism.

    Of course, I’m a grad student, so I’m used to reading that sort of stultifyingly formal prose. (I’m also the sort of nerd who’ll use “stultifying” in a sentence… posted to someone’s blog.)

  • 8. Audie's Gramma  |  December 5, 2008 at 1:26 pm

    Hey bluntobject, no worries.

    Some newer members of our SAR unit were taking a written test as part of an operational certification last week.

    One of the kids — very bright and thoughtful guy, but not a lot of formal education — waved me over and asked if I could define a word for him if it wasn’t part of the technical vocabulary we are “testing.”

    Okay, try me.

    “Incipient”

    “Uh, that means just beginning, or starting to develop.”

    “Oh. Okay then.”

    Later, the question comes up, who the hell puts a ten-dollar-word in a basic-level written test for search and rescue certification?

    Looked at the actual question, written about eight years ago when the training officer of the unit was … Oh hell. That would be me.

    Nevermind.

    Can I get a copy of the parental advisory you have on your blog?

  • 9. bluntobject  |  December 5, 2008 at 9:51 pm

    Can I get a copy of the parental advisory you have on your blog?

    I don’t have it in any higher resolution, so you can just right-click on the image and save it. Google image search should bring up quite a few alternatives, as well.

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